Cardiopulmonary Resuscitation, widely known as CPR, is an emergency procedure performed when a person’s heart has stopped beating, a condition called cardiac arrest. The technique combines chest compressions and, in some cases, rescue breaths to manually circulate oxygenated blood to the brain and other organs. Prompt action is necessary because permanent brain damage can begin within minutes after blood flow stops. Understanding the specific signs that indicate the need for CPR allows a bystander to quickly initiate this intervention.
The Immediate Indicators of Cardiac Arrest
The decision to begin chest compressions is based on two primary signs: a sudden loss of responsiveness and a lack of normal breathing. An individual in cardiac arrest will collapse and not respond to stimulation, such as being tapped on the shoulder or spoken to loudly. This unresponsiveness signifies that the brain is not receiving the blood and oxygen it needs to function.
The second indicator involves checking for breathing, which must be completely absent or clearly abnormal. Abnormality often presents as agonal gasping, a reflex that can sound like snorting, gurgling, or labored, infrequent gasps. This type of breathing is a sign of severe oxygen deprivation and confirms the need for immediate CPR. The focus for a layperson should remain on the person’s lack of consciousness and the absence of effective, normal respiration.
Essential Steps Before Starting CPR
Upon recognizing the signs of cardiac arrest, a rapid sequence of actions must occur before the rescuer begins chest compressions. The first step is to ensure that the surrounding area is safe for both the victim and the rescuer. A rescuer should never put themselves in danger from traffic, fire, or other hazards.
After establishing scene safety, the rescuer must immediately activate the emergency response system by calling the local emergency number, such as 911. If another person is present, assign them to make the call and locate an Automated External Defibrillator (AED). An AED delivers an electrical shock to restart the heart and is the definitive treatment for many causes of cardiac arrest.
The victim should be positioned flat on their back on a firm surface. This is necessary to ensure that chest compressions are effective. Compressing the chest against a hard surface maximizes the artificial blood flow. These preparatory steps must be executed quickly.
When CPR is Not Required
CPR is specifically designed to address cardiac arrest, so it is not appropriate for every medical emergency involving the heart. The procedure is not necessary if the victim is conscious, responsive, or able to move, even if they are experiencing acute distress.
A person experiencing a heart attack, which is typically a circulation problem caused by a blockage, is usually awake and their heart is still beating. CPR is also not required if the person is breathing normally, even if their breathing is shallow or very slow. The presence of normal breathing indicates that the heart is still circulating oxygenated blood, meaning the person is not in cardiac arrest.
In the event of a heart attack, the appropriate action is to call emergency services and keep the conscious person calm and resting while waiting for medical help. CPR should only be initiated when both responsiveness and normal breathing are absent.